Bottom Line:
CT coronary angiography has helped radiologists understand the variations and anomalies of the anatomy of the coronary arteries and, thus, to alert the cardiologist whenever such an anomaly is present.This can be of immense help to the clinician planning interventional procedures such as stenting, balloon dilatation, or graft surgery, particularly when there are secondary changes of calcification, plaque formation and stenosis.

ABSTRACTCT coronary angiography has helped radiologists understand the variations and anomalies of the anatomy of the coronary arteries and, thus, to alert the cardiologist whenever such an anomaly is present. This can be of immense help to the clinician planning interventional procedures such as stenting, balloon dilatation, or graft surgery, particularly when there are secondary changes of calcification, plaque formation and stenosis.

Figure 00012: ALCAPA. Sagittal MIP image igure (A) shows normal origin of the RCA (RC) from the right cusp. MIP image (B) reveals the LM originating from the PA — ALCAPA. Lateral coronary angiogram (C) shows a normal RCA (RC). Late phase of the same run (D) shows retrograde filling of the CX, LAD, and then the LM, which eventually opens into the PA

Mentions:
ALCAPA (anomalous origin of the left coronary artery from the pulmonary artery) [Figures 12], also termed as Bland-White-Garland syndrome (after the names of the persons who first described it in 1933). Usually an isolated anomaly, it is rare and is found in 0.25-0.5% of all congenital heart diseases, causing 90% mortality in the first year of life.[678] In this condition, the flow in the LM reverses and blood enters the PA due to low pulmonary resistance. This leads to coronary steal and hypoperfusion of the left myocardium, LV dysfunction, and congestive cardiac failure. Another form of this anomaly, with the RCA originating from the PA but shunting blood from the LM is also described.

Figure 00012: ALCAPA. Sagittal MIP image igure (A) shows normal origin of the RCA (RC) from the right cusp. MIP image (B) reveals the LM originating from the PA — ALCAPA. Lateral coronary angiogram (C) shows a normal RCA (RC). Late phase of the same run (D) shows retrograde filling of the CX, LAD, and then the LM, which eventually opens into the PA

Mentions:
ALCAPA (anomalous origin of the left coronary artery from the pulmonary artery) [Figures 12], also termed as Bland-White-Garland syndrome (after the names of the persons who first described it in 1933). Usually an isolated anomaly, it is rare and is found in 0.25-0.5% of all congenital heart diseases, causing 90% mortality in the first year of life.[678] In this condition, the flow in the LM reverses and blood enters the PA due to low pulmonary resistance. This leads to coronary steal and hypoperfusion of the left myocardium, LV dysfunction, and congestive cardiac failure. Another form of this anomaly, with the RCA originating from the PA but shunting blood from the LM is also described.

Bottom Line:
CT coronary angiography has helped radiologists understand the variations and anomalies of the anatomy of the coronary arteries and, thus, to alert the cardiologist whenever such an anomaly is present.This can be of immense help to the clinician planning interventional procedures such as stenting, balloon dilatation, or graft surgery, particularly when there are secondary changes of calcification, plaque formation and stenosis.

ABSTRACTCT coronary angiography has helped radiologists understand the variations and anomalies of the anatomy of the coronary arteries and, thus, to alert the cardiologist whenever such an anomaly is present. This can be of immense help to the clinician planning interventional procedures such as stenting, balloon dilatation, or graft surgery, particularly when there are secondary changes of calcification, plaque formation and stenosis.